1997 Volume 34 Issue 9 Pages 598-604
Twelve patients with hemiplegia due mainly to stroke (53.6±10.4yr, 5.5±2.2 weeks after onset) received 2 sessions of 2 week long intensive exercise therapy (IT) focussing on hemiplegic lower limbs, in addition to the basic traditional physical therapy (TT) for hemiplegia (ROM exercise, mat exercise, rising, sitting down, and walking). IT of the hemiplegic lower limbs included several kinds of assisted or voluntary movements of the lower limbs being coordinated and free from synergy which was necessary for normal walking. Each voluntary movement was repeated more than 100 times a day, with each patient paying strict attention to his or her movements. Evaluation was done using Ueda's scale, grading the independence from synergy, the number of foot tappings in 30 sec, and knee extension/flexion strength and speed measured with Cybex 6000. After 2 weeks of IT of the lower legs, Ueda's grade, foot tapping, and knee extension/flexion strength and speed significantly improved compared with those measured after an initial 2 weeks of TT. Similar improvements indicating the reduction of spasticity and synergy were also observed after a second session of IT. These functional recoveries after IT were considered not simply due to the improvements of brain edema and/or muscle strength, but the improvement of somecentral neuron network, i. e., brain plasticity, for voluntary movements. IT, rather than TT, will be necessary for advanced functional recoveries of hemiplegic patients.
